Psychosocial outcomes of an educational and environmental intervention among men in community residential treatment for substance abuse

People in recovery from substance addiction are at increased risk for poor diets, obesity, and diet-related chronic disease. This paper reports the psychosocial outcomes of Recovery Healthy Eating and Active Learning in Treatment Houses (RHEALTH), a theory-based nutrition intervention designed to increase the capacity for healthy eating among men in residential treatment programs. RHEALTH was pilot tested among men living in six urban residential treatment facilities. The intervention included weekly classes in nutrition and food preparation and changes in the food environment designed to increase access to healthy foods and self-efficacy and skills for choosing and preparing these foods. Baseline, pre-intervention and post-intervention assessments focused on changes in psychosocial constructs including self-efficacy for healthy eating and cooking, readiness to change diet, social support, and satisfaction with diet and weight. Socio-demographic and addiction characteristics, diet and body composition was also assessed. Data from 55 multi-ethnic men (53%) were included in the analyses. The intervention period was associated with improved self-efficacy for healthy eating and greater readiness to change diet over the control period. Class attendance was positively associated with satisfaction with diet and weight, and self-efficacy for healthy eating and cooking for participants who had longer time in treatment. The study results of this pilot intervention provide support for the use of educational and environmental strategies to increase dietary self-efficacy and readiness to change among men in residential treatment. A larger trial is needed to confirm the intervention effects on study outcomes.